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CD4+/CD8+比值与不稳定型心绞痛患者的冠状动脉斑块不稳定性呈正相关,但无法预测主要不良心血管事件。

CD4+/CD8+ ratio positively correlates with coronary plaque instability in unstable angina pectoris patients but fails to predict major adverse cardiovascular events.

作者信息

Chai Dayang, Kong Xiangquan, Lu Shu, Zhang Junjie

机构信息

Department of Cardiology, The First People's Hospital of Taicang, The Affiliated Taicang Hospital of Soochow University, Taicang, China.

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Ther Adv Chronic Dis. 2020 May 18;11:2040622320922020. doi: 10.1177/2040622320922020. eCollection 2020.

Abstract

BACKGROUND

The association between CD4+/CD8+ ratio and coronary plaque instability in patients with unstable angina pectoris (UAP) has not been investigated. We sought to elucidate the correlation between CD4+/CD8+ ratio and plaque instability in this patient population.

METHODS

We enrolled 266 UAP patients who underwent pre-intervention optical coherence tomography (OCT) examination and percutaneous coronary intervention in our center from January 2016 to January 2018. Features of coronary plaques in the culprit arteries were classified as unstable plaque and stable plaque. Primary endpoint was occurrence of a major adverse cardiovascular event (MACE). Receiver operating characteristic (ROC) analyses were used to determine the predictive efficacy of the CD4+/CD8+ ratio for a group of unstable plaque patients, and binary logistic regression analysis was performed to evaluate potential independent predictors of plaque instability. All-cause mortality and MACE between the two groups were analyzed.

RESULTS

UAP patients with unstable plaque had a higher CD4/CD8 ratio compared with stable plaque patients ( < 0.05). Results of binary logistic regression analyses showed that CD4+/CD8+ ratio ⩾1.725 and prior stroke were predictors and risk factors of plaque instability ( < 0.05). ROC analyses showed that CD4+/CD8+ ratio ⩾1.725 was predictive of plaque instability in UAP patients. However, the Kaplan-Meier estimate for MACE and all-cause mortality showed no statistical significance.

CONCLUSIONS

Higher CD4+/CD8+ ratio is associated with higher risk of plaque instability in our cohort of UAP patients. However, CD4+/CD8+ ratio was not an independent predictor of 1-year MACE or all-cause mortality.

摘要

背景

不稳定型心绞痛(UAP)患者的CD4+/CD8+比值与冠状动脉斑块不稳定性之间的关联尚未得到研究。我们试图阐明该患者群体中CD4+/CD8+比值与斑块不稳定性之间的相关性。

方法

我们纳入了2016年1月至2018年1月在本中心接受干预前光学相干断层扫描(OCT)检查及经皮冠状动脉介入治疗的266例UAP患者。将罪犯血管中的冠状动脉斑块特征分为不稳定斑块和稳定斑块。主要终点是主要不良心血管事件(MACE)的发生。采用受试者工作特征(ROC)分析来确定CD4+/CD8+比值对一组不稳定斑块患者的预测效能,并进行二元逻辑回归分析以评估斑块不稳定性的潜在独立预测因素。分析两组之间的全因死亡率和MACE。

结果

与稳定斑块患者相比,不稳定斑块的UAP患者CD4/CD8比值更高(<0.05)。二元逻辑回归分析结果显示,CD4+/CD8+比值⩾1.725和既往卒中是斑块不稳定性的预测因素和危险因素(<0.05)。ROC分析显示,CD4+/CD8+比值⩾1.725可预测UAP患者的斑块不稳定性。然而,MACE和全因死亡率的Kaplan-Meier估计无统计学意义。

结论

在我们的UAP患者队列中,较高的CD4+/CD8+比值与较高的斑块不稳定性风险相关。然而,CD4+/CD8+比值并非1年MACE或全因死亡率的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57e7/7238310/245b129d6818/10.1177_2040622320922020-fig1.jpg

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